Coronary giant cell arteritis and acute myocardial infarction
Pérsio Godoy1, Stanley de Almeida Araújo, Eduardo Paulino
1Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. pérsio@medicina.ufmg.br
Insights
Giant cell arteritis (GCA) can cause rare, fatal cardiac complications. This case highlights myocardial infarction and cardiac tamponade as exceptional causes of sudden death in GCA patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Pathology
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting large and medium arteries, primarily in the elderly.
- While GCA mortality is low, aortic rupture is a known, albeit rare, cause of death.
Observation:
- An 83-year-old woman undergoing GCA treatment experienced unexpected death.
- Autopsy revealed inflammatory changes in coronary arteries, thrombosis of the left anterior descending artery, and myocardial infarction.
Findings:
- The patient suffered rupture of the left ventricle's anterior wall, leading to hemopericardium and cardiac tamponade.
- This constellation of findings indicates myocardial infarction as the cause of sudden death.
Implications:
- Sudden cardiac death due to myocardial infarction is an exceptionally rare complication of GCA.
- This case underscores the importance of considering cardiac involvement in GCA patients, even during treatment.
Abstract:
Giant cell arteritis (GCA) is a systemic immune-mediated granulomatous vasculitis of large- and medium-sized arteries mainly affecting elderly people. Death from GCA alone is rare and usually results of ruptured aorta. In this paper is reported a case of a 83-year-old woman who unexpectedly died during treatment of GCA. Necropsy revealed inflammatory involvement of the coronary arteries with left descendent anterior artery thrombosis, myocardial infarct and rupture of the anterior wall of the left ventricle, as well as hemopericardium and cardiac tamponade. Myocardial infarction leading to sudden death is an exceptional complication of GCA.
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